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GRAM POSITIVE BACILLI (Small, non-spore forming (Nocardia spp (aerobic…

- - - - Resp droplet transmission: respiratory tract diphtheria --> pseudomembrane
      - Direct inoculation: ecthyma diphtheriticum --> vesicle/pustule --> scab --> punched-out ulcer
      - Toxin-producing strains: toxin inhibits protein synthesis. Toxin is systemically absorbed (CVS, CNS, kidney, liver, adrenals)
        
        Non-toxigenic invasive disease:
        
        endocarditis
        
        mycotic aneurisms
        
        septic arthritis
        
        osteomyelitis
  - - - PREVENTION: cook food, wash raw food, keep uncooked meats separate, avoid soft cheese if at increased risk
      - ADULTS:
        
        asymptomatic GIT carrier --> acute symptomatic infection
        
        influenza- like in pregnancy
        
        immunocompromised
        acute sepsis
        CNS: meningitis, encephalitis, abscess
        focal infections
        endocarditis
        food borne outbreaks
        
        febrile gastroenteritis
      - NEONATES:
        
        intrauterine infections
        premature labour
        still-born
        acute sepsis
        pustular skin lesions
        
        at delivery
        meningitis
- - - - found in soil
        
        highly resistant spores
        
        produces exotoxins
        
        transmission: ingestion of contaminated food
        
        self-limiting diarrhea (other infections may be systemic [device-associated], CNS, eye infections)
      - Onset of vomiting, abdominal cramps 1-6h; duration 10-24h
        Onset of watery diarrhea, abd cramps 8-16h; duration 12-36h
    - - maintained in soil as resistant spores
        
        primarily a disease of herbivores (zoonotic)
        
        humans infected by contact w/ diseased animals/products
        
        capsule & toxin-mediated pathogenisis
      - CLINICAL SYNDROMES:
        
        GIT (orapharyngeal, intestinal)
        
        cutaneous black eschar
        
        inhalation --> lung anthrax (biowarfare)